Nurses' perceptions of the social exclusion of patients with co-morbid mental health and substance misuse problems.

Abstract

The main aim of this research was to investigate nurses' perceptions of dual diagnosis clients in the context of social exclusion. The study also endeavoured to identify how these patients could be reintegrated and given value within the society. The methodology utilized for the study was a qualitative exploratory small-scale research through in-depth semi-structured interviews. This method was selected as the researcher required dynamicity and the ability to probe into the perceptions of nurses. A purposive sample of nine participants was selected and all agreed to participate. A pilot study was conducted with one interviewee and eight respondents took part in the actual research. The research instrument consisted of six open-ended questions. Data analysis was facilitated using Colaizzi's (1978) data analysis model. The main findings of the study were grouped into three major themes identified as: contrast between single and dual diagnosis patients; social exclusion of dual diagnosis patients; and prevention of social exclusion and re-integration. Important sub-themes which emerged in this section included the nurses' role, nurses' attitudes, the importance of social supports, and the impact of homelessness and unemployment. The key recommendations for research include an investigation into the dual diagnosis clients' perception of social exclusion. Whereas the most important recommendations for practice and education involve the proper identification of dual diagnosis clients, clearly defined roles for nurses and minimization of workers' negative attitudes through increased specialist knowledge and training.